Individual
AYLEEN GOMEZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, LMHC
Contact information
Practice address
PO BOX 411303, MELBOURNE, FL 32941-1303
(314) 668-2623
Mailing address
PO BOX 411303, MELBOURNE, FL 32941-1303
(314) 668-2623
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011039348
MO
Other
Enumeration date
01/13/2016
Last updated
06/19/2024
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